D'Souza M F, Swan A V, Shannon D J
Lancet. 1976 Jun 5;1(7971):1228-31. doi: 10.1016/s0140-6736(76)92172-3.
A controlled trial was undertaken to evaluate the practical consequences of screening in general practice. Of 2420 people aged 40-64 years examined in 1967-68, 191 (7.9%) had previously been told, at some time, that they had raised blood-pressure, other than during pregnancy. However, only 77 (3-2%) had any record of current antihypertensive treatment. Screening resulted in a further 50 persons (2-1%) being newly diagnosed as hypertensive in 1967-68 and a further 9 in 1969-70. Antihypertensive treatment was given to 21 of these immediately following diagnosis, while the treatment was adjusted in 23 of those already known to be hypertensive. In 1972-73 the blood-pressures of the screening population were directly compared with the control group. No significant differences in the distributions of their blood-pressure levels were observed. Over 95% of the new hypertensives discovered by the screening process in the control group in 1972-73 had visited their general practitioners for some reason during the previous five years. This suggests that "case-finding" by general practitioners would be more cost-effective than setting up separate blood-pressure screening clinics. However, the results of this study indicate that we need to know more about how raised blood-pressure can be successfully controlled over a long time, before any mass screening programmes can be actively encouraged.
进行了一项对照试验，以评估全科医疗中筛查的实际效果。在1967 - 1968年接受检查的2420名40 - 64岁的人群中，有191人（7.9%）曾在过去的某个时候被告知他们的血压升高，但不包括孕期。然而，只有77人（3.2%）有当前抗高血压治疗的记录。筛查导致在1967 - 1968年又有50人（2.1%）被新诊断为高血压患者，在1969 - 1970年又有9人。其中21人在诊断后立即接受了抗高血压治疗，而另外23名已知患有高血压的患者的治疗方案得到了调整。在1972 - 1973年，将筛查人群的血压与对照组直接进行了比较。未观察到他们血压水平分布的显著差异。在1972 - 1973年对照组中通过筛查发现的新高血压患者中，超过95%在过去五年中曾因某种原因看过他们的全科医生。这表明全科医生进行“病例发现”比设立单独的血压筛查诊所更具成本效益。然而，这项研究的结果表明，在积极鼓励任何大规模筛查计划之前，我们需要更多地了解如何长期成功控制血压升高的问题。
